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Exit Survey
 
 
Hello:


You are receiving this brief survey, consisting of 7 questions , in response to your recent request for help in looking at what your Health Benefit options are. Your answers will be used by our Benefits Counselors in assessing which plans from all the various Carriers in the U.S. would best be used in customizing the design of your specific Plan of Coverage.


We look forward to coming alongside you in this important matter. Please start with the survey now by clicking on the Continue button below.
 
 
 
Would you say that you are basically healthy and your main concern is simply having a Health Plan which serves as a good financial safety net against assuming too much medical expense debt?
 
 
 
On average, how many times a year, do you and those family members seeking coverage see a doctor for sick visits? (Total for you and family members needing coverage)
 
 
 
How important is it to you that your Preventive Care and Wellness visits be covered. For example: Pap Smears, Mammograms, Prostate Exams, Colonoscopy be covered?
 
 
 
How important is prescription drug coverage?
 
Not so Important
 
Important
 
Very Important
 
 
 
Are you replacing current Coverage or will you be picking up Coverage?
 
Replacing Current Coverage
 
Picking Up Coverage
 
 
 
Upon designing the Plan of Coverage which fits both your need and your budget, when would you want your Coverage to become effective?
 
Upon Approval
 
Within 30 days
 
Within 60 days
 
More Than 60 days
 
 
 
When would you like one of our Benefits Counselors to call you in order that we may discuss your options according to your choices?
 
Morning
 
Afternoon
 
Evening
 
Weekend
 
Request Specific Date and Time